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Home My WebLink About17718-zFORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Off~ce of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z17728 Date JANUARY 31t 1989 THIS CERTIFIES that the building Location of Property. 1070 VILLAGE LANE House No. County Tax Map No. 1000 Section 114 Subdivision ACCESSORY Block 06 Filed Map No. MATTITUCK Street Hamlet Lot 14 Lot No. conforms substantially to the Application for Building Permit heretofore filed mn this office dated DEC. 20~ 1988 pursuant to which Building Permit No. 17718Z dated DEC. 27, 1988 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ACCESSORY SHED AS APPROVED BY SOUTHOLD TRUST~. The certificate is issued to FRED & MARGAPJET E. GROMADZKI (owner, of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL UNDERWRITERS CERTIFICATE NO. PLUMBERS CERTIFICATION DATED ~_lding Inspector Rev. 1/81 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL SOUTHOLD, N. Y. BUILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) N~ 017718 Z Permlsston is hereby granted to' .... ~.~..~.....~.~.~..t~ ........... ..... z.~.z~....~..'~...*..?..~.....aT.~ ........ ..~..~..~..:~.,... ~......~.~.~.. ~....~.~_~ .......................................... premises located at County Tax Mop No 1000 Sechon ... /./~' .... pursuant to apphcat,on dated~~ '~,¢~. .... 19~ ~, and approved by the Bulldmg Inspector. Building Inspector Rev 6/30/80 TONN OF SOUTHOLD BUILDING DEPARTHENT TOWN BALL SOHTHOLD, NEW YORK 765 - 1802 11971 -- BLDG O~P[ TOWN OF SOUTNOLD APPLICATION FOR CERTIFICATE OF OCCHPANCY DATE NEW CONSTRUCTION ....... OLD OR PRE-EXISTING BUILDING ...... VACANT LAND ........ RODSE .0. STREET '~b~L;-~~ '" County Tax .ap .o. ]000 Section .//.~ Block .<)~.'.e~Lo= .~(~.qC' Subdivision ....................... Filed Map ........ Lot .......... Per,~it .o. /?.2/.~.~...Uate o~ ~ermit :~:.~.f.'.~pplieant ................... Health Dept. Approval .................. Underwriters Approval .............. Planning Board Approval ................ Request for Temporary Certificate ....... Final Certificate ................ Fee Submitted: rev. 10/14/88 u~d z. / 27Z~' FOUNDATION (1st) FOUNDATION (2nd)1 ROUGH FRAME & PLUMBING 3. INSULATION PER N. Y. STATE ENERGY CODE FINAL FRANK A KUJA'~SKI, JR , President ALBERT J KRUPSKI, JR , Vice-President JOHN M BREDEMEYER, llI JOHN L BEDNOSKI, JR HENRY P SMITH BOARD OF TOWN TRUSTEES TOWN OF SOUTHOLD Town Hall, 53095 Mare Road P O Box 728 Southold, New York 11971 PHONE 765-1892 December 16, 1988 Fred Gromadzki 1070 Village Lane Mattltuck, N.Y. 11952 Dear Mr. Gromadzki: The following action was taken by the Board of Town Trustees during their regular meeting held on December 15, 1988 as follows: WHEREAS Fred Gromadzki, applied to the Town Trustees for a waiver to construct a storage shed on property located at 1070 Village Lane, Mattltuck, N.Y., identified on Suffolk County Tax Map as 1000-114-6-I7, WHEREAS the Town Trustees have conducted an on site inspection of the subject property, and NOW THEREFORE BE IT RESOLVED THAT THE Southold Town Trustees approve the request for a WAIVER for above mentioned project. Please re~urn to the Building Department for a determination on the need for any other permits which may be required for this project. FAK:jas cc: Bldg. Dept. Board of Appeals file Very truly yours, Board of Town Trustees BOARD OF HEALTH ...... 3 SETS OF PLANS ....... FORM NO. I SURVEY .......... TOWN OF SOUTHOLD CHECK .......... BUILDING DEPARTi~/IENT SEPTIC FORM ............. : TOWN HALL SOUTHOLD, N Y. 11971 TEL.. 765-1802 Examlned~ .-3., .-1, 19.~ Appros~ 4-1 , 19'~ Pemmt No. ~ "t~ ~! ~ q:~ (BudJmg Inspector') APPLICATION FOR BUILDING PERMIT Disapproved a/c CALL ................ MA I L" BLDG, DEPT _ TOWN O[ Date .., 19. INSTRUCTIONS a Ttus application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, w~t sets of plans, accurate plot plan to scale. Fee according to schedule b. Plot plan showmg location of lot and of buildings on premises, relationship to adjoining premises or pubhc str~ or areas, and giving a detmled description of layout of property must be drawn on the dmgmm which m pag of thru ap cat~on. c The work covered by t~s application may not be commenced before msu~ce of Building Permit d. Upon approval of this apphcatmn, the Building Inspector will issued a Building Pe~t to the apphcant Such pet sh~ be kept on the premmes available for mspectmn throu~out the work e. No building shall be occupied or used in whole pein p~t for any purpose whatever until a Ce~ificate of Occupa shall have been grated by the Building ~¢spectqr~ . ~PLICATION IS HEREBY MAD~o tile ~m[~g Dep~ment for the ~ssuance of a Bmldmg Pemlt pursuant to Buil&ng Zone Ordinance of the Town of Southold~ Suffolk County, New York, ~d other apphcable ~ws, Ordm~ce Regulations, for the constmc~on of bugdmgs, add~Qons or alteratmns, or for removal or demoh~on, as hereto descnl The apphcant agrees to comply w~th ail apphcable laws, ordtnances, building code, h~,smg code, ~j regulations, admit authorized mspectom on premises and ~ braiding for necessa~ ~nspechons ~,.... ~._ (S~gnadtre df~hcant, or ~me, ~f a corporahon) (Malhng address of apphcant) II ~ State whether apphcan~ ~s owner, lessee, agent, architect, engineer, general contractor, electrician, plumber or bmh Name of owner of pm~fses . ~ ~7 ~ ~ ~ ~O ~ ~ ~ ~ ) ¢7 ,- . O~ "~ (as on the tax roIl or latest deed) If apphcant is a oo~g~g~a~re of duly author]zed officer (~me and o¢ co~orate officer) ALL CO~TRACTOR~S HUST Bg SUffOLK COURTY Bmlder's License No .... Plumber's License No .. Electrician's L~cense No Other Trade's License No Location of land on which proposed work will be done House Number Street County Tax Map No 1000 Section //~ Block Hamlet Subdivision Filed Map No Lot (Name) State existing use and occupancy of premises and ~ntended use and occupancy of proposed constructmn a. Existmg use and occupancy a//////'~' ~,.,#.'~7;~','e.~. fo-~ b Intendeduseandoccupancy .. ~..~ ,~ ~-t.g ~w-q;~. ~..~'.. . Repmr ... Removal . . Estimated Cost...~.. ~.. 7~.? · .'5~.. If dwelling, number of dwelling units Nature of work (check whlch apphcable) New Building . /h . Addition .... Alteratmn Demolition ...... Other Work . ... .. ... Fee... .. ....... .. .... .. . .. . .. ~' (to be paid on filing this application) Number of dwelling units on each floor. ---. ...... 5 If garage, number of cars -- . ......................... 6 If business, commercial or mixed occupancy, specify n~ure an~l extent of each type of use ' ' . 7. Dlmenslo,ns,o~et~structures, lfany. Front ~.~..-'P~. ~/.~. Rear Height . Y ~t ~F~~ . Number of Stones .. / ~'7~.'~ .'Z". ............. Dm3ensions of same structure with alterations or addltmns Front .... Rear ............. Depth ......... Height .... Number of Stones ............. 8. Dimensions oi~ent~re..~..~ew construction Front '/.~.~.7"~ ii Rear ../.X..~...?~... Depth d~../~..7-. ... Height . ~..Cf ..... Number of Stones ................................... 9 S~ze of lot Front /oo~.'~ ~ ....... Rear ,~..f ~.~ ~:..~.. .... Depth ~2,v~'~,~7~ ......... 10 Date of Purchase //~ ~//~ ....... Name of Former Ow,e~ l 1 Zone or use dlstnct m wk:ch pren.;3es ale situated .......... 12 Does proposed construction vmlate any zoning law, ordinance or regulation . ~.~. ......... 13. W~I1 lot be regraded .. . ~-,. ~/o ........ Will excess fill be removed from premises Yes N 14. Name of Owner of premises ~[~¢F ~'~.~ ~ ~..~.~/.~.l .. Address/.~' ~.~.~..re..~..~ .... Phone No .~.~.-.~/o.. Name of Architect .............. Address .......... Phone No .......... Name of Contractor/'r~'~{ ~..°{-z'4'..~. o?~ ~.~t~/g.~. Address ............. Phone No ......... 15. Is this property located w~thin 300 feet of a tidal wetland? *Yes ..... No .:.~.. *If yes, Southold Town Trustees Permit maybe required. ' PLO'I' DIAGRAM Locate clearly and d~stinctly all buildings, whether existing or proposed, and.~ndicate all set-back dxmenslons fro~ property hnes Give street and block number or descnptlon accordmg to deed, and show street names and mdlcate whethc mtenor or corner lot APPROVED AS NOTED DATE'/.~.a.."Zf ~ 8 NO~ BUILDING OEPAR~ME~T 765~1802 9 AM TO a ~ ~C~ ~E FOLLOWING ~NSPECT 1. FOUNDATION ~0 REQUIRED FOR POURED CONCRETE [ ROUGH- FRAMING & PLUMBING $. IRSU~IION 4. FINAL CONSTRUCTION MUST 8E ~MPL~E FOR C.O ~ ~~N SHALL ME~ ~A~ ~~ & ENERGY ~ ~ ~la~ FOR D~N ~ ~N ~RORS STATE OF NEW YORK, COUNTY OF. SS (Name of individual S~gmng contract) above named · being duly sworn, deposes and says that he is th? appl~cai He is the ......... (Contractor, agent, corporate officer, etc ) of said owner or owners, and ls~duly anthonzed to perform or have perfonned the said work and to make and file th apphcat~on, that all statements contained m this apphcatmn are true to the best of his knowledge and behef, and that tl~ work will be pea-formed in the manner set forth m the application filed therewith. Sworn to before me this ...l?.. day of ... ~??u7/ .......... 19.,.~.. Notary Public, fl~I. EN K. DE VOE NOTkRY PUBLIC, State,of New York No 47078t8, Suffo,k County~o Tern' £xmtes ~ch 30, 19 -o / ~'~ ~re ofapphcan